| NPI | 1992180376 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: TX 40348) |
| Additional Taxonomies | 122300000X Dentist (Licence: NJ 22DI02607900) |
| 1223P0221X Dentist, Pediatric Dentistry (Licence: NY 058860) | |
| Enumeration Date | 2015-07-27 |
| Last Update Date | 2025-08-11 |